S省基本医疗服务均等化的时空演化分析——基于2015~2024年21个市(州)面板数据

Spatio-Temporal Evolution Analysis of Basic Medical Service Equalization in Province S—Based on Panel Data of 21 Prefecture-Level Cities from 2015 to 2024

摘要: 基本医疗服务均等化是完善基本公共服务体系、提升居民健康福祉的重要议题。本文基于2015~2024年S省21个市(州)的面板数据，采用熵值法构建基本医疗服务均等化综合指数，运用核密度估计、Dagum基尼系数、变异系数及泰尔指数刻画其时空演化特征。结果表明：(1) 研究期内S省基本医疗服务均等化水平持续提升，综合指数均值由2015年的0.2581升至2024年的0.4600，增幅达78.2%；(2) 区域差异显著缩小，变异系数由0.4378降至0.2200，泰尔指数由0.0913降至0.0239；Dagum基尼系数由0.2384降至0.1188，分解后组内、组间和超变密度三类分量协同下降但下降幅度不一，差异主导成分由“组间差异与超变密度并立”转向“组间差异主导”，组间差异贡献率由42.81%升至59.77%；核密度估计显示分布呈现“中心右移、波宽收窄、双峰弱化”的动态特征。研究为优化S省医疗资源空间布局、推进基本公共服务均等化提供了经验依据。

Abstract: The equalization of basic medical services is vital to improving the basic public service system and residents’ health welfare. Based on the panel data of 21 prefecture-level cities and autonomous prefectures in Province S from 2015 to 2024, this paper constructs a comprehensive index of basic medical service equalization using the entropy weight method, and explores its spatio-temporal evolution characteristics via kernel density estimation, Dagum Gini coefficient, coefficient of variation and Theil index. The results indicate that: (1) The equalization level in Province S kept rising steadily, with the average comprehensive index increasing from 0.2581 in 2015 to 0.4600 in 2024, an increase of 78.2%; (2) Regional disparities decreased significantly. The coefficient of variation dropped from 0.4378 to 0.2200, the Theil index from 0.0913 to 0.0239, and the Dagum Gini coefficient from 0.2384 to 0.1188. The decomposed intra-group disparity, inter-group disparity and hypervariable density declined collaboratively at different rates. The dominant disparity source shifted from the joint effect of inter-group disparity and hypervariable density to inter-group disparity, whose contribution rate rose from 42.81% to 59.77%. Kernel density estimation presents dynamic distribution features of rightward central shift, narrowed bandwidth and weakened bimodal distribution. This study provides empirical reference for optimizing the spatial distribution of medical resources and promoting basic public service equalization in Province S.